Thirty-two patients with 41 injured arteries were operated upon during a period of 12 years. Three quarters were men, and the median age was 33 years. Accompanying lesions were seen in 87.5% of the patients. Nearly half the lesions were related to blunt trauma. Occupational accidents constituted the largest group. The diagnosis was made on clinical grounds in most cases. The median time lapse from trauma to operation was 5 hours. The principles of treatment were those that are generally accepted. No patients died, the amputation rate was 12.5%. Median follow-up was 8 months. A successful arterial reconstruction contributed to a good functional result. Postreconstruction thrombosis of arteries were found to occur within the first hours or days after reconstruction. Late thrombosis was rare and the overall long-time patency was 61.4%. Patency of repair of upper limb small vessels was 54.5%.

Adolescent↗

PubMedDate not supplied

The value of sigmoideoscopy in the diagnosis of ischemic colitis following aortic reconstruction.

During a 4 1/2-years period sigmoideoscopy was performed when patients developed diarrhea and/or unexpected low abdominal pain within the first days following aortic reconstruction. In our investigation rigid sigmoideoscopy, revealed all the cases of major ischemic colitis.

Abdominal Pain↗

PubMedDate not supplied

Non-cardiac creatine kinase-B activity in serum after abdominal aortic bypass surgery.

Serum creatine kinase (CK) and creatine kinase isoenzyme MB (CK-B) were measured and electrocardiogram (ECG) recorded preoperatively and 24, 48 and 72 hours and 7 days after abdominal aortic bypass grafting in ten patients. No ECG abnormality indicating acute myocardial infarction (AMI) appeared and no patient had chest pain. CK-B was below the discrimination value for AMI in all cases preoperatively, but increased significantly after the operation to a maximal median value of 15 (range 5-32) U/l at 48 hours. The time-activity curve of CK paralleled that of CK-B, reaching a maximal median value of 814 (range 289-1972) U/l at 48 hours. On day 7 CK and CK-B had normalized. The CK-B activity relative to CK activity remained below 6% in all patients. Elevated serum CK-B activity should be utilized with caution for the diagnosis of perioperative AMI in patients undergoing aortic bypass grafting.

Aged↗

PubMedDate not supplied

Severe hypophosphatemia following elective abdominal aortic bypass grafting.

Serum phosphate levels and urinary phosphate excretion were investigated in ten patients undergoing elective abdominal aortic bypass grafting. The abdominal aorta was cross-clamped peroperatively for 50-95 min. The median serum phosphate was within reference range (0.80-1.55 mmol/l) during cross-clamping and for the first 24 hours after revascularization of the lower limbs. At 48 hours there was statistically significant fall in the serum phosphate level in all patients, with median reaching a nadir of 0.49 mmol/l. At 72 hours this level had risen to 0.69 mmol/l, and reference range had been regained 7 days postoperatively. The median urinary phosphate excretion (mmol) was 38.4 during the first 24 postoperative hours, and 34.7 and 10.0 on the 2 subsequent days. The median ratio of urinary phosphate to creatinine clearance was, respectively, 0.47, 0.37, 0.09 and 0.08 on postoperative days 1, 2, 3 and 7. The study indicated that patients undergoing aortic bypass grafting with protracted regional muscular ischemia may constitute a risk group with respect to development of severe postoperative hypophosphatemia.

Aged↗